IgA肾病患者血清IgA1异常糖基化与氧化应激关系的研究  

Relationship between abnormal glycosylation of serum IgA1 and oxidative stress in patients with primary IgA nephropathy

作　　者：刘书馨[1] 刘红[1] 陈琛[1] 王媛媛 王伟[1] 康喆 Liu Shuxin;Liu Hong;Chert Chert;Wang Yuanyuan;Wang Wei;Kang Zhe.(Department of Nephrology, Dalian Murticipal Central Hospital, 116033 Dalian, China)

机构地区：[1]大连市中心医院肾内科,116033

出　　处：《中国医师进修杂志》2018年第1期5-9,共5页Chinese Journal of Postgraduates of Medicine

基　　金：大连市卫生和计划生育委员会项目（2013）

摘　　要：目的 探讨IgA肾病（IgAN）患者血清IgA1异常糖基化与氧化应激的关系。方法 选取2012年1月至2013年12月行肾穿刺活检确诊为IgAN患者52例，其中Lee分级Ⅰ~Ⅲ级且估算肾小球滤过率（eGFR）≥ 60 ml/min 41例（IgAN-A组），Lee分级≥ Ⅲ级且eGFR 〈 60 ml/min 11例（IgAN-B组）。另外选择69例健康体检者作为对照组。采用蚕豆凝集素亲和酶联免疫吸附法检测血清O糖链N-乙酰半乳糖胺低糖基化IgA1（Gd-IgA1），采用液相色谱法检测血清终末氧化蛋白产物（AOPPs）。结果 IgAN-B组尿蛋白及血尿素氮、肌酐和尿酸明显高于IgAN-A组[（3 613 ± 2 247）mg/d比（1 457 ± 1 342）mg/d、（8.30 ± 2.92）mmol/L比（5.46 ± 1.55）mmol/L、（155.09 ± 57.97）μmol/L比（77.50 ± 22.55）μmol/L和（466.73 ± 120.97）μmol/L比（361.70 ± 94.40）μmol/L]，白蛋白和eGFR明显低于IgAN-A组[（36.45 ± 4.71）g/L比（39.37 ± 3.97）g/L和（50.71 ± 26.50）ml/min比（94.67 ± 23.48）ml/min]，差异有统计学意义（P〈0.05）。IgAN-A组与IgAN-B组IgG、IgA、IgM、C3和C4比较差异无统计学意义（P〉0.05）。IgAN组血清Gd-IgA1和AOPPs明显高于对照组[0.44 ± 0.17比0.15 ± 0.06和（120.3 ± 48.5）μmol/L比（45.7 ± 19.2）μmol/L]，差异有统计学意义（P〈0.05）；IgAN-B组血清Gd-IgA1和AOPPs明显高于IgAN-A组[0.59 ± 0.23比0.35 ± 0.12和（159.4 ± 50.2）μmol/L比（90.9 ± 41.7）μmol/L]，差异有统计学意义（P〈0.05）。IgAN组患者血清Gd-IgA1和AOPPs水平呈正相关（r= 0.603，P〈0.05）。结论 IgAN患者血清异常糖基化可导致氧化应激水平的升高，且IgAN患者血清Gd-IgA1和AOPPs水平与IgAN的进展相关，提示Gd-IgA1联合AOPPs可能成为IgAN的治疗和预后判断新的生物学标志物。Objective To study the relationship between abnormal glycosylation of serum IgA1 and oxidative stress in patients with primary IgA nephropathy （IgAN）.Methods Fifty-two primary IgAN patients diagnosed by renal biopsy from January 2012 to December 2013 were selected. In the patients, Lee grade Ⅰ- Ⅲ and estimated glomerular filtration rate （eGFR） ≥ 60 ml/min 41 cases （IgAN-A group）, Lee grade ≥ Ⅲ and eGFR 〈 60 ml/min 11 cases （IgAN-B group）. Sixty-nine health examination volunteers were selected as control group. The serum galactose-deficient IgA1（Gd-IgA1） was detected by enzyme-linked immunosorbent assay for vicia lectin, the advanced oxidation protein products （AOPPs） was detected by liquid chromatography.Results The urinary protein, urea nitrogen, creatinine and uric acid in IgAN-B group were significantly higher than those in IgAN-A group： （3 613 ± 2 247） mg/d vs. （1 457 ± 1 342） mg/d, （8.30 ± 2.92） mmol/L vs. （5.46 ± 1.55） mmol/L, （155.09 ± 57.97） μmol/L vs. （77.50 ± 22.55） μmol/L and （466.73 ± 120.97） μmol/L vs. （361.70 ± 94.40） μmol/L, the albumin and eGFR were significantly lower than those in IgAN-A group： （36.45 ± 4.71） g/L vs. （39.37 ± 3.97） g/L and （50.71 ± 26.50） ml/min vs. （94.67 ± 23.48） ml/min, there were statistical differences （P〈0.05）. There were no statistical differences in IgG, IgA, IgM, C3 and C4 between IgAN-A group and IgAN-B group （P〉0.05）. The serum Gd-IgA1 and AOPPs in IgAN group were significantly higher than those in control group： 0.44 ± 0.17 vs. 0.15 ± 0.06 and （120.3 ± 48.5） μmol/L vs. （45.7 ± 19.2） μmol/L, there were statistical differences （P〈0.05）. The serum Gd-IgA1 and AOPPs in IgAN-B group were significantly higher than those in IgAN-A group： 0.59 ± 0.23 vs. 0.35 ± 0.12 and （159.4 ± 50.2） μmol/L vs. （90.9 ± 41.7） μmol/L, there were statistical differences （P〈0.05）. There was a positive correlation between Gd-IgA1 and AOPP

关 键 词：肾小球肾炎 IGA 糖基化 氧化性应激 

分 类 号：R692.31[医药卫生—泌尿科学]